Csb of East Central Ga

NPI #1164753703 in Hephzibah, Georgia

Provider Information

NPI Number
1164753703
Entity Type
Organization
Organization Name
Csb of East Central Ga
Primary Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Jan 21, 2010
Last Updated
Jan 21, 2010

Practice Location

Address
2657 TEAKWOOD DR
State
Georgia
ZIP Code
30815-6000
Phone
(706) 432-4858

Authorized Official

Name
WANDA JESSIE
Title
BILLING MANAGER
Phone
(706) 432-4858

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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